Category: Health

My labor and delivery nurse has encouraged me to write about and share my birthing experience with Rosalie since it was so calm and actually, quite nice. She mentioned that women often come into the hospital hoping for a natural birth, but haven’t prepared for it. So here is a little background on my previous birthing experience, information about how I prepared for my second birthing experience, and Rosalie’s birth story….which is long and boring (fortunately for me). I wrote this in random times between my girls’ naps, in the middle of the night, etc, so excuse the length and grammatical errors.

Seton’s birth (my first), while wonderful and miraculous, was somewhat of a doozy. I went into labor with the plan of getting an epidural and hopefully coasting through delivery. I knew that labor/delivery rarely went exactly according to plan, so I was fairly open to the idea that things might change. I was very fortunate that I progressed well and she was able to be born safely, but the epidural didn’t work. Well, it worked for about two glorious hours, then for some reason just stopped. The nurses had me turning on my sides, changing how much the bed was reclined, and even called in the anesthesiologist to alter the placement and dosage (when I was at 9 cm). It was miserable feeling stuck in the bed through transition. I remember telling them to let me sit up better in bed because I was going to push whether they liked it or not–the urge to push was so strong. I was wishing I didn’t even get the epidural because then at least they would let me get out of bed.

I decided I would prepare for a natural, unmedicated birth for my second child, and if I were to need an epidural I would get one. I knew that this time around, I needed a strategy for dealing with contractions. I kept thinking that birthing is the most natural and common thing in the world–every person in the world has experienced it–it shouldn’t be so traumatic.

Like I said, I want to emphasize the importance of preparation. Here are some key ways I prepared for birth:

1). Home study course with Hypnobabies.
2). Listening to the recommended tracks daily.
3). Eating healthy (eh, I should say MOSTLY eating healthy) and exercising.
4). Listening to Fear Free Childbirth podcast on my way to/from work. I LOVED hearing women’s birthing stories that WEREN’T all about pain, trauma, and drama.
5). This sounds SUPER weird of me, but I think it REALLY helped….watching youtube videos of hypnobirths. You know how athletes do mental imagery before big games/meets? Seeing calm births helped me envision myself having one. The only other births I’ve ever “witnessed” were from movies, and we all know those are completely unrealistic. But that’s what we imagine going into labor….so wrong!

My sister-in-law told me about hypnobirthing and sent me her home study guide. I read Marie Mongon’s book as well as Ina May Gaskin’s Guide to Childbirth. The more I read about healthy, natural, calm birthing experiences, I knew that it was possible for me as well. One thing I love about hypnobirthing is the emphasis on staying relaxed. With my background in physical therapy, I completely understand how tensing up can increase your pain and put you at greater risk for birth injuries.

I started around week 28 of my pregnancy going through the home study guide and listening to the recommended hypnosis tracks every day. I remember thinking at the beginning of the home study that there was no way I could be hypnotized. I was envisioning Davey having to dangle a watch in front of my eyes and tell me I was getting veeeery sleepy…., but that’s not how it works. It’s more like being hypnotized in the same way as when you are watching TV or reading an article on your phone and you somehow completely drown out your spouse (sorry, Davey). I was able to drown out everything while I was having pressure waves (pressure waves is the hypnobirthing term for contractions). My focus was entirely on staying relaxed. This took a lot of practice leading up to the birth. I think I was able to easily go into my relaxed state during Rosalie’s birth because I had practiced it so much (every day).

September 10, 2016 at the Wayzata James J Hill Days Fair; the day before my contractions started

Okay, onto the boring birth story!

I woke up on Sunday, September 11 (6 days after the due date my doctor gave me but EXACTLY on the due date I gave myself based on Fertility Awareness Method/NFP I have to add-ha!) at 2am with some pressure under my belly. This was very different than the crampy contractions I had with Seton, so I wasn’t sure it was “it.” But they started coming every 7-8 minutes and were pretty intense, so I decided to put on a hypnobirthing track with my headphones. At some point between 2am and 7am I went to the bathroom and Davey woke up saying, “is this it?” I was pretty dumb and said, “Yes! They’re 7-8 minutes apart, so maybe the baby will be here by noon!” HA! I laugh at that so much now–

Seton woke up at 7am and contractions slowed to 30 minutes apart (or more) throughout the day. It was a fairly relaxing day–I watched ‘The Intern’ with my mom and sat on the porch as Seton played with Davey in the corner. Every time a pressure wave came on, I closed my eyes and breathed in for a count of 4 and out for a count of 8 and focused on staying relaxed. I was a little anxious and upset that contractions had slowed down and that extra time allowed some fear to creep back in–what if it’s too painful? What if it’s as bad as last time? I debated going for a walk to “speed things up,” but then wondered why there is always a push to “speed things up” with birthing? What’s the rush? The pressure waves were tolerable. I was home. I was eating and moving and feeling well. The baby was healthy–I felt her kicking. I decided it was best to relax since I knew I would need energy later. At some point I laid back down in my room and listened to a Fear Release track that was intended to help me let go of any fear I have with birthing–I think I fell asleep and had a nice nap. I also remember deciding wash and straighten my hair since I knew I wouldn’t be able to for a few days (priorities, ladies).

We went to bed around 10 that night and pressure waves started up again around 11pm. I started timing them–and again they were 7-8 minutes apart. I wanted to focus on staying relaxed, so I woke Davey up to time them. I regret this–at the time, I thought things would REALLY pick up quick and we would be leaving for the hospital soon. They were 7-8 minutes apart ALL NIGHT and poor Davey didn’t sleep a wink. I was able to sleep between pressure waves as I was listening to relaxing tracks. I kept waiting until the “under 5 minutes for an hour” rule to head to the hospital. I was afraid they would just slow down again during the day, and I didn’t want to be at the hospital for that. 7am rolled around again, and Seton was calling to us to get her out of her crib. I couldn’t believe I was still home!

We sent her to daycare–(I gave her one last hug as my one and only and was a little emotional knowing her life was about to change so much)– and by that point I was a little frustrated, tired, and slap happy. We don’t have a birthing ball, so I was jokingly bouncing on one of Seton’s blow up horses, and my mom and I had some good laughs. I decided to take a bath, then try to sleep a little. I laid in my room by myself, listened to some tracks, and fell asleep. Every time I felt a pressure wave, I hit the “lap” button on my iPhone’s stopwatch, barely opening my eyes. I laid like that for almost two hours. When I decided I should use the bathroom, I looked at the timer and saw that I had been having contractions just 3-4 minutes apart for 2 hours. I couldn’t believe it! I had been so relaxed, it felt like I was sleeping between pressure waves that were 20 minutes apart.

I told Davey about the timing and asked him to make me lunch (love him) while I called my doc and told her I was headed to the hospital.

As we were walking out the door, I felt fear creep back in a bit. I hugged my mom (who was staying with us to take care of Seton) and held back a few tears–hugging my mom before giving birth was really emotional because I knew she had gone through all this FOR ME before. I felt very appreciative of her and truly felt life coming full circle.

I got in the car and said to Davey, “I can’t believe Mary rode a DONKEY through this!” The pressure waves were definitely more intense, and I was nervous about going through transition on the way to the hospital. I turned on my Birthing Day hypnobirthing track and put my ear buds in and kept my eyes closed the whole way. (this was MUCH different from driving to the hospital with Seton when I was yelping in pain). We were at the hospital so fast—time seemed to be nonexistent that day. I think we arrived shortly after 12:00.

Davey quickly told the nursing staff that I was doing hypnobirthing, and I did NOT want to know how dilated I was. I didn’t want to be told I was 3 cm after laboring for a day and a half–I would have felt so defeated. I also didn’t want to know if I was really close because I didn’t want to become fearful or anxious. I just wanted to BE. From everything I have read about dilation, it doesn’t really matter. It doesn’t predict how close or how far you are from birthing your baby. Things can “speed up” or “slow down.” So I just wanted things to go as they should.

A few weeks before Rosalie’s birth, my doctor informed me the nurses at the hospital were on strike. I LOVED my nurses with Seton, so I panicked a bit and wondered if the replacement nurses would be as skilled. Davey and I decided to pray every night for our labor/delivery nurse. After I was checked and determined to be in true labor, a very sweet nurse came in and introduced herself–LeShanta. Davey again told her we were doing hypnobirthing, and she responded by telling us she is also a certified doula and has been present for many other hypnobirths. I literally got goosebumps—we had been praying for her. God was present, and I KNEW that everything would be ok. It was like God was saying, “I have planned this out for you. Just let go.”

Walking out of the triage room, I felt a strong pressure wave. I stopped to do my breathing, and LeShanta whispered in my ear, “spread your feet apart” as she put her hand on my shoulder–a hypnobirthing cue to relax and release. Such small things, but the gentle reminders helped me so much.

When we got the to labor/delivery room, I just wanted to lay on my side and listen to my tracks. I did. I kept my eyes closed. Davey would occasionally give me sips of water or Gatorade and remind me to get up and pee. I wanted him to keep his hand on my low back during pressure waves…for some reason it felt like some of the energy went to him, which was wonderful. I remember one pressure wave was so intense that I clenched my fists. LeShanta gently opened my fingers which was enough of a reminder to me to relax.

The doctor came in around 3:00 (I think? I just remember her saying, “I’ll be back at 3:00” after I initially got to the room). She asked me to lay on my back (my thoughts: NO! PLEASE NO!). I did. She checked my dilation and just as she was checking, the strongest and by far the most painful pressure wave came on. I said, “OUCH! THIS IS THE WORST YET! OUCH!” and I heard LeShanta whisper, “Release” with her hand on my shoulder which immediately relaxed me and brought me back to my breathing. It was like the contraction was instantly not painful anymore–just pressure. That’s when I realized my hypnobirthing was VERY SERIOUSLY WORKING if I just stay in the zone. I had gotten out of the zone when the doctor was checking me.

The doctor left the room after telling me, “don’t push yet. We aren’t ready.” I laid back on my side. LeShanta told me I should put my earbuds back in because she was going to be getting the room ready and didn’t want me to get distracted. A few contractions later, I felt my body push Rosalie down. I told LeShanta, and she whispered, “that’s okay. It’s doing what it’s supposed to.”

When the doctor came back in, I had a couple gentle pressure waves, then another where my body pushed Rosalie down (very neat feeling!). The doctor immediately yelled “she’s delivering!” and had me lay on my back. Being on my back was a little miserable and not my first choice. I do wish I had told the doctor to let me birth on my side. It was so much more comfortable. I got out of my “zone” when trying to get in the right position, but LeShanta calmly whispered things in my ears that helped me get back and birth my baby easily. (voice of an angel!) The doctor mentioned the baby was being born in the water bag and she was breaking it as Rosalie was on her way out.

A few minutes later at 3:35pm and Rosalie was in my arms.

It turns out I was 7cm when I got to the hospital and 9cm when my doctor checked me around 3pm (and when I had that intense contraction). The whole time I was at the hospital I was anticipating the dreaded “transition” that everyone talks about. I didn’t realize until my body started pushing Rosalie out that I had already passed transition. I never once had the thought of “I can’t do this anymore” which is apparently the classic sign of transition. THANK YOU, HYPNOBIRTHING.

I felt so good after her birth. It felt so normal and natural; I loved that I wasn’t hooked up to monitors and could get up whenever I needed to use the bathroom. I had been snacking and eating, and laying on my side the whole time so I wasn’t completely drained. LeShanta was so calm. She kept the lights dim, spoke in soft tones, and never showed and sense of hurry. It was great.

I told LeShanta a few days ago that Rosalie is such a calm baby, and speaking of research, she said: “Mothers who have natural, relaxed labors, and who have practiced relaxation throughout pregnancy have more peaceful and laid-back babies.” I have SOOOOO witnessed that with Rosalie. Aside from a little fussiness since her 2 month shots, she has been such an easy baby. She’s very calm and happy.

I highly recommend preparing for labor with hypnobirthing, even if you’re 100% set on pain meds or if you need a C-section. It will help so much to get you through pressure waves and to have a relaxing pregnancy.

Being a woman is the greatest–we have both the physical strength to grow a human within us and bring that human into the world as well as the emotional strength to selflessly give our bodies so that someone else can have life.

Giving birth to my children is my greatest accomplishment and my greatest joy.

Thanks so much for reading through my series on the Kegel muscles (aka pelvic floor). I hope that I was able to help you in some way. Here are some questions people emailed, texted, or asked me personally after reading through my posts.

I am a mom of 5 children who were each delivered via C-section. Why are my vaginal muscles weakening? What are the best exercises and best diet plan (if that is a factor)?

Even though your children were delivered via C-section, the weight of carrying around a child (or 5) was enough pressure on your pelvic floor to stretch it out. Other factors, like your posture and sleeping position, can weaken your pelvic floor. The good news is that you can strengthen it! I recommend reading through my posts and adjust your posture and incorporate a daily routine of strengthening your Kegels. If you feel like you need more help, see a physical therapist.

I sometimes get a sudden urge to pee and have to run to the bathroom. If I don’t make it in time, I leak urine. Will strengthening my Kegels help prevent this?

This is a good time for me to bring up the different types of incontinence: urge, stress, overflow, and functional.

Urge incontinence is what is described in this question and occurs when there is an urgent need to rush to the bathroom. There can be many reasons for this, so I recommend discussing it with your doctor before attempting to strengthen your Kegels.

Stress incontinence occurs due to an increase in abdominal pressure like coughing, sneezing, or laughing. Pelvic floor strengthening is usually helpful for this type of incontinence. I also recommend that when you are coughing, laughing, or sneezing you contract your Kegels and your abdominals. You would benefit immensely from seeing a physical therapist.

Overflow incontinence occurs when you are not able to completely empty your bladder, so when it fills up again, you leak. This may occur because of a number of medical reasons, so I recommend speaking to your doctor if you feel this is the case.

Functional inctontinence occurs when a physical problem prevents you from getting to the bathroom on time.

Take ownership of your health! You CAN change your incontinence problems, so don’t sit around in silence due to embarrassment. Seek help so you can change your life for the better! If you seek professional help and are only put on a medication, I encourage you to ask more questions. Ask your practitioner which type of incontinence describes your condition and if physical therapy may help–whether you are male or female!

I leak urine when I cough and sneeze. It all started when I was about 15 weeks pregnant. I told my ob-gyn at one of my prenatal appointments, and she told me to cross my legs when I cough or sneeze. Is this what I should be doing?

Um, with all due respect to your ob-gyn, NO. Crossing your legs when you sneeze to prevent the leakage of urine might be a quick fix because it literally pulls the pelvic floor muscles taut. Pulling the muscles taut overtime STRETCHES them. A muscles that is overly stretched out is much harder to contract. Therefore, crossing your legs can weaken the muscles overtime and perpetuate the problem. I recommend contracting your Kegels and your abdominals (as instructed here) when you cough/sneeze/laugh rather than crossing your legs. Also, take yourself through the exercise progression.

I was told to strengthen my Kegels, I should contract the muscles on and off when I am peeing to make them strong. Is this a good exercise?

I have a lot of patients who tell me they do Kegel exercises when they are peeing, and I die a little bit inside every time I hear it because of the sacral micturition reflex. (the who-sa-what-a?!?!?!) Ever since our potty-training days, the act of sitting on the toilet signals our brain to tell our pelvic floor muscles, “okay, relax now” and tells our bladder “okay, contract now” so pee comes out. When we change that up by doing the OPPOSITE—that is, a kegel exercise–we screw up all that work our parents did to potty-train us. And what did we do before they potty trained us?

We peed our pants.

Don’t mess with the potty-training reflex.

Do your exercises away from the porcelain throne.

I am having pain during intercourse. How is this related to my pelvic floor?

First of all, you are not alone. It’s estimated that 20-50% of women have pain with intercourse. This means that possibly half of your friends may be experiencing the same problem! I am not going to offer much advice about this aside from saying there is a good chance it can be fixed with physical therapy. Talk to your ob-gyn and see what he/she thinks. Ask if you can have an order for physical therapy. You won’t be disappointed, and you may start having a little more fun in the sack. 😉 You can thank me later.

***The content of http://www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on http://www.kayleemay.com. Taking recommendations presented on http://www.kayleemay.com is solely at your own risk***

Kegel muscles, or pelvic floor muscles, are just like any other muscle in your body in a sense that contracting them against gravity is a greater chore than using gravity to your advantage. This is important to remember when you decide how to go about strengthening your kegels.

SIDELYING

The position that is most helpful in contracting your Kegels is the sidelying position. Lie on your side with your top leg supported on pillows so that your hip is in a neutral position. Tighten your Kegel muscles as though you are stopping the flow of urine. I often cue people to imagine the pelvic floor is an elevator. Imagine ropes attached to your ribs. As you contract, the ropes are pulling the elevator (pelvic floor) toward your rib cage. Exhale as you are contracting.

If you are holding your breath, the opposite will happen–your pelvic floor will expand toward your feet (eek!) just like a parachute expands when it meets air resistance. This stretches the pelvic floor, making it hard to contract and can weaken it over time. Hold each contraction 5-10 seconds. Repeat 10-20 times.

(side note: If you feel like you can’t contract your pelvic floor in this position, please see a physical therapist! To see one, ask your doctor–possibly your obgyn–for an order to see a physical therapist who specializes in women’s health….even if you are male! They are the gurus of the pelvic floor. You can also see a PT through direct access.)

QUADRUPED

Another position that is “gravity-lessened” for the Kegel muscles is the quadruped position. On your hands and knees with your knees directly below your hips and your hands below your shoulders, contract your pelvic floor as described above while exhaling. Make sure your back is flat.

In this position, I also encourage you to contract your abdominal muscles as you contract your kegels. Do this by pulling your belly button toward your spine. Again, if you are holding your breath and/or bearing down, your stomach expands, and the increased volume actually stretches your pelvic floor and abdominals like a parachute stretches when it meets air resistance (aka don’t do that). Hold 5-10 seconds and repeat 10-20 times.

SITTING

It may take a few weeks, but once you are able to complete the above positions correctly, you can move to a sitting position for your Kegel work out. 😉 In this position, you are lifting your Kegels against gravity, so it is much more challenging. Contract your pelvic floor muscles by thinking of lifting them up toward your rib cage as described above. Hold 5-10 seconds and repeat 10-20 times.

STANDING

Next, try to contract your Kegels in standing. Think of raising your pelvic floor up toward your ribs with the elevator ropes as described above as you exhale.

The most challenging way to contract and exercise your Kegels is to perform contractions during your normal movements, such as arising from a chair. Start by contracting the muscles in sitting and keeping them contracted as you move to stand.

If you are active in fitness and exercise, keep these tips in mind as you lift weights and move through your exercise routine. Remember, if you hold your breath, you are expanding your pelvic floor (like when a parachute meets air resistance) and stretching them out which can weaken the muscles over time.

(Feel free to leave a comment below (you can leave one anonymously!) or send an email to kayleemayblog at gmail dot com with any questions. If I get enough questions throughout this series, I will post a Q&A post to conclude it)

***The content of http://www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on http://www.kayleemay.com. Taking recommendations presented on http://www.kayleemay.com is solely at your own risk***

When I am treating a patient in the clinic, I make sure to talk about daily positions and movements that affect their condition before educating them on exercises. The reason is that the positions and movements we perform repetitively each day will affect our bodies more than spending 15-30 minutes a day exercising. It’s incredibly important to treat our bodies well by first integrating good posture and movements into our daily habits.

First, I will address sleeping position because it’s one of the most important positions our bodies assumes that determines which muscles are stiff and which ones are too flexible. A sleeping position is like holding a stretch for hours at a time. It might seem like Kegels wouldn’t be impacted by our sleeping position, but if our hips are internally rotated and/or adducted (knee rolled inward and past midline), the pelvic floor muscles are stretched out because they actually attach to the hip bone itself (by way of the fascia of the obturator internus). So when the hip moves “inward” it pulls on the pelvic floor muscles. This happens when we lay on our side without the top leg supported. If you are a side sleeper, I recommend putting one to two pillows between your knees and feet to support your top leg in neutral.

(I promise I don’t sleep on tile floors)

Second, I will address our sitting position. I don’t care who you are–you sit a lot. If you sit in bad positions like this

Again, if our legs assume an “inward” position, our Kegel muscles are pulled taut, therefore stretched. You know how little kids look when they have to pee? They pull their knees in. That’s because that pulls the muscles taut. Over time, that position stretches the muscles, making them harder to contract. It is best to sit in a neutral position. I encourage you to modify your desk set up to make sure you are treating your Kegels well when at work!

Lastly, our standing position can impact our Kegel muscles. Standing with your hip hiked and legs crossed puts your muscles in an asymmetrical position (ahem MOMS who let a kid sit on one hip all the time). Not only will it lead to back pain, hip and back muscle asymmetries, but can weaken the pelvic floor over time.

Another bad position for your pelvic floor muscles in standing your “tail” curled under too much. Yoga and pilates classes stress tucking your tail bone (which can be a good cue to get those abs and gluts to contract) BUT this places the pelvic floor directly under the torso nice and flat so that ALL the pressure from your internal organs rests on it, weakening it over time when it’s a habit. (yes, I know you don’t FEEL heavy pressure just standing there…but there is a such thing as gravity, folks)

So don’t stand like this

or this

or this

or this

Stand in a neutral position like this:

This may seem like nit-picky advice and may even seem unreasonable to do (especially ALL THE TIME), but try to start incorporating good posture and movements into your daily routine to take care of your body.

(Feel free to leave a comment below (you can leave one anonymously!) or send an email to kayleemayblog at gmail dot com with any questions. If I get enough questions throughout this series, I will post a Q&A post to conclude it)

***The content of http://www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on http://www.kayleemay.com. Taking recommendations presented on http://www.kayleemay.com is solely at your own risk***

I first heard about Kegel muscles in college. My roommate with a deep southern accented read us an article about Kegel muscles out loud from a magazine. Due to her strong accent, we all thought she was saying “giggle” muscles. Based on what she was reading, that seemed like an appropriate name for those particular muscles. 😉

Fast forward about four years to physical therapy school, and I ended up learning a lot more about Kegel muscles than what could be read in a magazine. For example, did you know…

Kegel muscles are the pelvic floor muscles, or the base/foundation of our torsos that support our uterus, rectum, small intestine, and bladder.

Kegel muscles are relaxed when we urinate or defecate and are contracted when we are not urinating or defecating.

Since these small muscles hold up our organs, function as the base and foundation of our bodies, and are so closely associated with frustrating medical conditions like incontinence, I thought it would be a good idea to do a series on the Kegel muscles.

Stay tuned to learn if you need to strengthen your Kegel muscles and how to go about doing that!

(Feel free to leave a comment below (you can leave one anonymously if you want!) or send an email to kayleemayblog at gmail dot com with any questions. If I get enough questions throughout this series, I will post a Q&A post to conclude it)

***The content of http://www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on http://www.kayleemay.com. Taking recommendations presented on http://www.kayleemay.com is solely at your own risk***

Diastasis recti, a separation of your abdominal muscles, is a common condition during and after pregnancy.

The linea alba is a line of fibrous tissue between two sides of the rectus abdominis that runs vertically. When this muscle is stretched throughout pregnancy, there can be a physical separation or widening between the two sides of the abdominal muscle.

As outlined in previous posts, the abdominals act as a natural back brace for us. If there is weakness or separation in our natural back brace, a number of pain conditions arise. Unfortunately, diastasis recti is not always recognized early, and I see mothers of all ages in the clinic for hip pain, back pain, knee pain (etc, etc, etc) that arose from weak abdominals. (side note: Obgyns should just start referring women to physical therapists after any type of birth, right?)

I searched the web to find a quick video of how to tell if a diastasis recti is present. I found this video you can use to assess for the presence of this condition:

Let’s all freak out for a minute because we all just realized we have diastasis recti…

ok, I’m still freaking out…

still freaking out…

ok, now I am desperate to fix this!

How convenient there is a post right here about postpartum abdominal strengthening!

There is one thing to add to this strengthening program if you find that you have diastasis recti. Use your hands (or a brace, etc) to physically pull your abdominals together as you perform the exercises. In other words, push your abs together.

I want to note a few things you should most definitely NOT do if diastasis recti is present:

3. YOGA positions where you are pushing your stomach out (aka abdominal breathing, dead bug, to name a few), yoga positions that STRETCH the abs (cobra), or anything on your hands and knees with poor abdominal control (cat, cow, sunbird).

5. Did I already say don’t do sit ups? Just don’t. If you want strong abs, do this.

I strongly encourage you to seek help from a physical therapist if you have a significant diastasis recti. There is nothing like having an expert treat you one on one to prevent and treat pain. I am not speaking of a personal trainer or fitness guru, although they are helpful for many things. A physical therapist is a movement system expert with a physical therapy degree (7 years of post high school education for a doctorate degree) and has been up close and personal with the rectus abdominis and line alba a la cadaver labs. TMI?! I just want to be clear that seeing a personal trainer is NOT the equivalent.

Your health insurance may help you out with the cost of physical therapy. If you don’t want to see a doctor first to get an order for physical therapy, call your local PT clinic and see if they have direct access. If you don’t know what direct access is, please read my explanation here.

***The content of http://www.kayleemay.com is for informational purposes only. The information presented is not to be taken as professional medical advice, diagnosis, or treatment. If you are having pain, or seeking medical advice, talk to your health care provider. Do not delay in seeking treatment because of information you have read on http://www.kayleemay.com. Taking recommendations presented on http://www.kayleemay.com is solely at your own risk***

Sometimes it seems like breastfeeding is a sport. It requires concentration, endurance, a balanced diet, practice, patience, and sheer determination.

The more you do it, the more weight you lose. (insert thumbs up emoji)

The more you do it, the more you are prone to injury. (insert thumbs down emoji)

Breastfeeding can cause back pain, neck pain, shoulder pain, and wrist pain. Each pain condition is directly related to posturing while nursing. The good news is, posture can be easily adjusted to reduce the risk of pain associated with breastfeeding.

In this post, I will discuss the most common breastfeeding positions and talk about how they can cause pain and what you can do to prevent the pain.

The key to good breastfeeding posture is taking the time to prepare for the nursing session. Your baby might be screaming his precious little head off, but take 5 extra seconds to think through your position and set up before latching on the starving little babe.

CRADLE HOLD

Source: BabyCenter.com | Positions and tips for making breastfeeding work

I’ve never personally done this position because…ouch. Seton was born at a whopping 8 pounds, 10 ounces and (obviously) has only been getting bigger. I was NOT ABOUT to hold that weight in the crook of my elbow for 15+ minutes at a time. In the picture above, one can see the weight of the baby will pull the entire right shoulder blade forward which subsequently rounds out the upper back.

This picture also shows the mother tenderly looking down at her child. Let’s all let out a group sigh…”awwww”… and then let’s never do that. Looking down at your infant for the duration of the feeding causes the muscles on the back of your neck to work really hard for a really long time in a really elongated position. Really. And that’s a workout those muscles just don’t need. (did I say “really” enough to make my point?)

A better option is to place the infant on a stack of pillows (and/or a boppy) to take the pressure off the supporting arm and shoulder. Once the baby is latched, keep your neck tall and look forward. Alright, you can peak at the cutie pie once in a while.

To prevent lower back pain, make sure your feet are supported and not just dangling from the couch or rocking chair. Sit evenly on your buttocks. If you have one foot tucked under your hips, your back is in a bent and rotated position that can cause pain.

THE CROSS OVER HOLD

Source: BabyCenter.com | Positions and tips for making breastfeeding work

This is similar to the cradle hold, but the position of the arms are switched. For this position, I suggest to make all the changes recommended above.

These two positions put an enormous amount of pressure on the arms and pull your upper back forward. Unless you’re going for the hunchback look, USE PILLOWS to support the baby!

Also make sure your back is fully supported. In some chairs your feet may not reach the floor if your back is supported on the back of the chair. In this case, you may need to use pillows behind your back to support your back and allow your feet to touch the floor.

THE CLUTCH OR FOOTBALL HOLD

Source: BabyCenter.com | Positions and tips for making breastfeeding work

This position is great for so many mothers including those with large breasts, those with twins, and those who have had a Cesarean section.

As you may have guessed, I recommend placing the infant on pillows so you take out the work your arm would have to do. Sit with your back supported so that the arm that is guiding the infant’s head does not have the tendency to pull your shoulder girdle forward and cause your back to round out. As always, once the infant is latched, keep your head up and look forward. Your feet should be supported.

THE RECLINING POSITION

Source: BabyCenter.com | Positions and tips for making breastfeeding work

Great was the day that I mastered this position because it meant I did not have to sit on my postpartum bum. (TMI?) This is also a great position if you have low back pain. Just remember to support your head with pillows so your neck is in a neutral position. I’ll take this moment to refer to my post on the Ergonomics of Sleep where I mention the importance of keeping your neck in a neutral position while laying down. Don’t prop your head up with your hand like the ever-so-informative cartoon shows above.

To summarize the dos and don’ts of breastfeeding:

DON’T support the weight of the baby with your arms.

DO rest the infant on pillows and/or a boppy (I use a boppy and pillows galore and have remained pain free).

DON’T look down at your baby for the duration of the feeding…(or your Kindle, Nook, or iPad…)

DO keep your neck in a neutral position.

DON’T allow legs to dangle or be crossed under your booty.

DO make sure feet are flat on ground or stool to take pressure off the low back.

The ice is melting. The sun is shining. The warmer temps are calling our names.

Before you lace up your running shoes and inhale in your first deep breaths of spring air, stop to read these injury prevention tips for runners.

Buy the right shoes.

Who needs an excuse to buy new shoes? Not this girl. But if you’re looking for one, here are three.

Buy new shoes if…

1. There is any breakdown in your current running shoe (aka your shoes are old!)
2. You have been running on a treadmill all winter and are switching to land.
3. You have been using your running shoes for walking.

Make sure to choose the right running shoe for your foot. You can read about how to choose the right shoe here.

Ease into outdoor running.

Your first outdoor routes of the season should be on level ground, then gradually start working in inclines and different terrain. Trail runs (personal fave) can quickly bring on ankle injuries if you haven’t worked up to them.

Pay attention to what your body is trying to tell you.

Muscles aches the day after running are signs your muscles are changing and adapting in good ways. Localized pain, sharp pain, or joint pains are signs you should ease off a bit.

Check to see if your local physical therapy clinic has a “Running Clinic” where your run can be analyzed, and you can get pointers on how to improve your stride!

Knee pain is one of the most common conditions I treat. To fix it, I alter a lot of bad habits and reorganize the way my patients move in basic daily tasks. I wish that I was somehow able to go back 10, 20, 30 years and tell my older patients these 3 easy ways to protect their knees from pain. Knee pain may have a small genetic component, but it can be entirely prevented through using our movement systems as they were designed to be used.

1. Sit in a mechanically aligned position. Don’t cross your legs. Crossing your legs places the hip and knees out of alignment, causing certain muscles to stiffen (I’m looking at you, IT band) and other muscles to lengthen (the gluts). Any muscle imbalance around the hips and knees causes the knees to move in a faulty pattern. When sitting, make sure to keep your knees aligned with your feet. If your feet point outward, but your knees point straight ahead, you are likely twisting your knee joint.

2. Use good mechanics when getting up from a chair. Your knees should be aligned with your feet. As women, we tend to allow our knees to move together, or inward, when rising to stand and/or when sitting down. This causes relatively more pressure on the outside of our knees and stretches the ligaments on the inside of the knees, making the knee less stable. If you think about how many times we stand up and down in our lives, this can lead to enough wear and tear to cause knee pain.

3. Don’t hyperextend. When you are waiting in line in the grocery store, talking to friends after church, or doing dishes, unlock your knees. It may be tiresome to stand with your knees unlocked, but overtime it will become a habit and prevent your ligaments from getting so loose that they lose the ability to truly stabilize your knee.

Share with all your friends lest you want to spend retirement writing “Get well soon” cards for everyone who had knee replacements.

I made the mistake that so many people make when first doing Whole30. I didn’t consume enough calories to keep up my breastmilk supply. I also skipped pumping sessions at work, which certainly didn’t help. I began to panic as I saw the freezer stash deplete day after day and had to have the tough conversation with Davey as to whether we should buy formula. I said to him, “I’ll stop doing Whole30 before I buy of formula.” I’ve been so determined to breastfeed for a year–not that using formula is bad–but I really enjoy breastfeeding. As a working mom, it’s the one thing that only I can do for Seton. She has other people put her down for naps, feed her solids and bottles, etc, etc. Selfishly, I wanted to keep breastfeeding for just her and me.

I’m not a quitter. I was confronted with the dilemma of quitting breastfeeding or quitting Whole30.

So I decided I needed to find a way to keeping doing both.

The main thing I realized through reading things on the interweb is that I am not consuming enough calories. I used to eat cereal, yogurt, bagels, sandwiches that gave me plenty of calories to feed triplets (ha!). I went from calorie heaven to … well… a lot of lettuce and sweet potatoes. I have done 3 things to bump up my calorie intake in a healthy, Whole30 compliant, way.

1. I make a smoothie each morning. I drink half in the morning, then half when I get home from work. It contains:

4 cups water
2 bananas
1 cup blueberries
3 cups spinach

It tastes good (sweet from the fruit!), forces me to drink more water (extremely important for breastfeeding) and bumps my supply right back up. We aren’t encouraged to drink our calories, so I also make sure that I eat a hearty breakfast, lunch, and dinner.

2. I put a scoop of canned coconut milk in my coffee. I’m a black coffee kind of girl, but I’m trying to add healthy fats and calories where I can. This is a quick and easy solution that doesn’t rob coffee of its enriching flavor.

3. I make homemade almond butter. I throw a few cups of almonds in the food processor, grind for about 15 minutes (an exercise of patience), and then spread on celery sticks, carrots, apples, etc. It’s a quick way to eat good, healthy fat. And it tastes really good.

I would like to say I am also drinking a ton of water, but that one is still really hard for me. I don’t have the luxury of running to the bathroom every 30 minutes at work, so yeah. But I am trying!